Influence of Partial Payment in the Healthcare System to the Behavior Having a Medical Care

Abstract

The healthcare system in Japan requires people to pay both insurance premiums and a partial payment of the cost of medical care. Previous studies have shown that the rationale behind this partial payment is unclear, with moral hazard being the primary reason for its existence. The concept of partial payment did not exist in Japan’s initial Health Insurance Law, but it was introduced as public finance for medical insurance deteriorated. Partial payment is understood to be the price of receiving medical care in the hospital, and partial payments serve as a gatekeeper of medical care for low-income and economically disadvantaged individuals.

In this study, we conducted interviews with individuals exempted from partial payments, such as those benefiting from free/low-cost medical services. In addition to economic reasons, we observed that two factors influence their behavior when seeking healthcare. The first is their work environment, and the second is their family environment during childhood. Therefore, they are thought to be less aware of their healthcare needs and less likely to seek medical care. Although there is free access to Japan’s healthcare insurance system, it is believed that access to medical care is not adequately guaranteed for economically disadvantaged individuals.